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腹腔镜次全子宫切除术后的长期结局

Long-term outcomes following laparoscopic supracervical hysterectomy.

作者信息

Lieng M, Qvigstad E, Istre O, Langebrekke A, Ballard K

机构信息

Department of Gynaecology and Obstetrics, Ullevål University Hospital, Oslo, Norway.

出版信息

BJOG. 2008 Dec;115(13):1605-10. doi: 10.1111/j.1471-0528.2008.01854.x. Epub 2008 Aug 25.

Abstract

OBJECTIVE

Evaluation of long-term outcomes following laparoscopic supracervical hysterectomy (LSH).

DESIGN

Retrospective postal questionnaire.

SETTING

Norwegian university teaching hospital.

POPULATION

A total of 315 consecutive patients.

METHODS

A questionnaire sent to all patients who underwent a LSH during 2004 and 2005.

MAIN OUTCOME MEASURES

Persistent vaginal bleeding and pelvic pain, patient acceptability of such symptoms and patient satisfaction following LSH.

RESULTS

A total of 240 women (78%) completed the questionnaire. About 24% reported experiencing vaginal bleeding up to 3 years following their hysterectomy, although this was rated as minimal in 90% of cases, resulting in a mean bothersome score of 1.1 (SD 2.0) on a 10-point visual analogue scale (VAS). Women operated on by less experienced surgeons were more likely to report vaginal bleeding following surgery (P = 0.02). About 74% of women reported having menstrual pain prior to surgery, with a mean score of 6.8 (SD 2.1) (10-point VAS). Up to 3 years following surgery, 38% continued to experience menstrual pain, although this was significantly less intense with a mean score of 3.5 (SD 2.2) (P < 0.01). While all women reported a decrease in the amount of pain experienced following the hysterectomy, those having a hysterectomy because of endometriosis reported significantly higher levels of menstrual/cyclical pain after surgery compared with women who had a hysterectomy for other reasons (P < 0.01). Ninety per cent of women reported being satisfied with their surgery.

CONCLUSION

Although vaginal bleeding and pelvic pain are frequently observed following LSH, these symptoms are significantly reduced and patient satisfaction is high.

摘要

目的

评估腹腔镜次全子宫切除术(LSH)后的长期结局。

设计

回顾性邮寄问卷调查。

地点

挪威大学教学医院。

研究对象

共315例连续病例。

方法

向2004年至2005年期间接受LSH的所有患者发送问卷。

主要观察指标

持续性阴道出血和盆腔疼痛、患者对此类症状的接受程度以及LSH术后患者满意度。

结果

共有240名女性(78%)完成问卷。约24%报告子宫切除术后3年内有阴道出血,不过90%的病例中出血量被评为极少,在10分视觉模拟量表(VAS)上的平均困扰评分为1.1(标准差2.0)。由经验较少的外科医生实施手术的女性术后更易报告阴道出血(P = 0.02)。约74%的女性报告术前有痛经,平均评分为6.8(标准差2.1)(10分VAS)。术后3年内,38%的女性仍有痛经,不过疼痛程度明显减轻,平均评分为3.5(标准差2.2)(P < 0.01)。虽然所有女性均报告子宫切除术后疼痛程度减轻,但因子宫内膜异位症接受子宫切除术的女性术后经痛/周期性疼痛水平显著高于因其他原因接受子宫切除术的女性(P < 0.01)。90%的女性报告对手术满意。

结论

尽管LSH术后常观察到阴道出血和盆腔疼痛,但这些症状明显减轻,患者满意度较高。

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